how would he NOT know [if I'm type 2] ? I mean I am 41, never been told i was diabetic before 3/16/09... What can I do to be sure?

He wants to see me in 2 weeks for a follow-up..Then he will decide about the insulin.. Do many people only take their insulin at night? Especially if they're on oral meds too? He said that the insulin is the kind that you can increase every night slowly..

Metformin helps the body use the insulin you produce more effectively. Sometimes our bodies react differently to various drugs, so what might work for you might not work for me. There are other meds besides metformin. Byetta is one of them and it works differently than metformin. I think that's why it's important to give the body and the meds time to see if the blood sugar can get down to better levels, but if your body is not manufacturing enough insulin to begin with, then there's not enough of it for the meds to work with. I don't know. Maybe you need more time to get the blood sugar down with the meds you're taking. Maybe the doctor thinks you're not producing enough insulin. There are tests that measure the amount of insulin the pancreas puts out. I hope more members pop in here who can give information about how insulin is used.

Hi there,One of the things to keep in mind about diabetes meds is that there are drugs (Metformin, Actos, Avandia, glyburide, etc) and there are hormones (insulin). One is synthetic and the other is something the body produces naturally.

With all types of diabetes, it is a condition that does not allow our bodies to metabolize carbohydrates effectively. Sometimes our pancreas does not produce enough/any insulin, sometimes our cells are not receptive to receiving the insulin in our system, and sometimes it's a combination of both.

For a doctor to determine which category you fall under, a number of tests, personal history, lifestyle, blood glucose levels (BGLs), and more need to be considered. Unfortunately, there is no one test that can make the determination. Metformin is one of the first drugs prescribed for those thought to be Type2/insulin resistant. It does take some time for the body to climatize to the drugs so, you can probably expect to see your doc in 2-3 week intervals until your BGLs settle into an acceptable range. This is normal procedure - get you on a drug that'll help your body use the insulin it produces more effectively. Next would be a drug that will help your pancreas produce more insulin. Next or in some cases, INSTEAD of a drug that makes your pancreas work harder, insulin might be prescribed to "supplement" the body's stores. There is a belief among some docs that it is better to preserve the body's insulin production by not stressing it out with drugs but by supplementing with the insulin it needs instead.

Most importantly...Diet plays a huge role in Diabetes. I understand you've got some nutrition classes coming up? It's what we put in our mouths that directly affects our blood sugar levels. Understanding nutrition is vital for managing this condition. Following the "nothing white but cauliflower & cottage cheese" diet plan is often a good place to start while you're learning more about nutrition and it's own effects on you personally. Everyone's situation differs slightly and the only way to know just how particular foods affect your BGLs, is to test. It may seem like a pain for a while but, if you really want to make sense of your diabetic situation, you need to start a log book (if you haven't already). Note every BGL test, food, meds, exercise, and the times for each. I guarantee you'll start to see patterns pretty quickly. Even if you just do it for a while, the information you'll be able to share with your doc(s) will be invaluable to them in helping put you on the right course of action. I still do this every day.

I can also tell you, as someone who injects insulin 5-7 times/day, it's not nearly as bad as the finger picks If you ever do get put on insulin, it would probably be a long-acting (works over 24 hour period), like Lantus or Levemir. Both are once a day, or in some cases like me (Type 1), twice a day, injections. I use injection needles that are much finer than the finger pick stick and don't even feel them. Just want to say not to fear insulin if that's the route your doc wants to go.Cheers,- Phishbowl (Type 1 since Jan'05 - Levemir, NovoRapid)"What's Not Measured Is Not Managed"

"It is impossible for a man to learn what he thinks he already knows"-Epictetus

I was on nightly insulin for about two years and it's not too much hassle. It helps with your sugars when you can't get them down any other way. I was unable to exercise much because of some leg injuries and the insulin was a lifesaver. After my injuries healed I was able to get my weight down a bit with some diet changes and exercise. I was able to go off the insulin (for now) so there is hope that you may do the same. If you have any fears or questions you can email me directly to the email I read every day, ok?It's jeannie143 at sbcglobal dot net~ Jeannie, Forum Moderator/Diabetes & FibromyalgiaI know God will not give me anything I can't handle. I just wish that He didn't trust me so much. ~Mother Teresa

"People are like stained glass windows: They sparkle and shine when the sun's out, butwhen the darkness sets in, their true beauty is revealed only if there is light within."- Elizabeth Kubler-Ross

First and foremost are you on regular metformin or extended release metformin. If you are on regular metformin then talk to your doctor about extended release metformin as it usually works much better for Type two diabetics. The reason for this is simply that the extended release metformin controls and regulates the distribution of metformin into your system. Many people who make that change start to see a difference in their blood sugars.

As for insulin, I am not the guy to ask. Byetta is not insulin, it is a derivative of heila monster saliva that changes the way that your stomach empties. You take a shot once before breakfast and once before dinner. I am on the 5 mcg dose right now and don't see that changing in the near future.

Lani really has it right. You need to be your own detective and work to find out what foods make the most problems for your blood glucose levels. I am always playing around to see what works best. It is a long drawn out process, but keep with it.

Ask your doctor about extended release metformin and give that a try. If that does not work as if Byetta is an option.